AV Junction

Conducts the impulse through the fibrous plate that separates the atria and the ventricles; consists of the AV node and the bundle of His; functions also to slow the conduction speed to allow for atrial conduction prior to ventricular conduction (atrial kick); also serves as a pacemaker if the SA node fails to fire.

The atrioventricular (AV) node is a rounded bulbar structure of specialized cells similar to the SA node. The AV node also has intrinsic automaticity, with the ability to serve as a pacemaker in case of SA nodal failure. The AV node usually does not initiate impulses, though, as its intrinsic firing rate is normally 40-60 /minute, slower than the SA node. Remember, the fastest pacemaker site rules.

The AV node has a second important role. The AV node and the bundle of His slows impulse conduction to allow the atria time to contract prior to ventricular contraction. In other words, the AV junction provides the time delay for an atrial kick. The time taken to cross the small AV junction is 10-12/100 of a second (a significantly lengthy period for such a small structure).

The bundle of His serves as an electrical connection between the atria and the ventricles, traversing the fibrous plate that separates the atrial and ventricular electrical systems. The AV node and Bundle of His form the AV junction (sometimes just called the junction).

Note that the AV junction, atria and SA node are the three main supraventricular (located above the ventricles) electrical sites. This is an exceptionally simple and important distinction. As you will soon discover, in order for an impulse to be transmitted down the bundle branches, the impulse must be supraventricular in origin.

Figure 3.1 The Heart’s Electrical Pathway

A wave of depolarization normally begins with the SA node. This electrical wave from the SA node passes quickly across the atria, through the AV junction (the AV node and the bundle of His) then across the ventricles via the bundle branches and the Purkinje network.

1. Six Second ECG Guidebook (2012), T Barill, p. 46, 49, 109, 191

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Dynamic ECG rhythm interpretation
Static ECG rhythm interpretation
Clinical Impact Mapping
Acute Coronary Syndromes Overview
Acute Coronary Syndromes In-Depth
ST Segment & T Wave Differential
Identify Bundle Branch Blocks
15 | 18 Lead View Mapping
Electrical Axis
R Wave Progression
Left Bundle Branch Blocks with ACS
Atypical Findings
Acute Non-Ischemic Disease Conditions
Special Cases

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